Paying the Price

Hospital district officials wanted a simple one-sentence policy on immigrant health care. What they got instead was a criminal probe and plenty of politics.

But he's not losing any sleep over the investigation.

"Even if there's an indictment…to convince a jury of 12 people that somebody knowingly, intentionally or recklessly tried to break the law would be a very, very high burden," the former prosecutor says.

Rosenthal acknowledges that he is still trying to figure out who, if anybody, committed a crime. The possibilities, he says, include members of the hospital district board, its administration, county commissioners, even health care providers.

"If this was a marathon run, we're in the first couple of hundred yards in terms of knowing where we're going to be ultimately or how the race will turn out," he says.


Back at Casa Juan Diego, Pat McColloster says that despite the unresolved litigation, services to the undocumented have become more consistent.

"It's gotten significantly better, but there's still significant need," he says in a New Orleans brogue. "There are still a lot of people who can't get" a gold card.

These days McColloster spends much of his time as a social worker, brokering conference calls between his patients at Juan Diego and hospital district registration centers. That way, he says, any confusion over necessary documents will get resolved before the patient goes to apply for a gold card.

The most important thing, the physician says, is to make sure no more of his patients fall through the cracks. On that day in 1997 when the ailing house cleaner showed up unexpectedly at the clinic, McColloster treated her hypertension. But it was her massively swollen arm, on the same side of her body as the breast that had been removed, that really worried him.

He made her another appointment to get a gold card to resume chemotherapy. Weeks passed and he didn't hear back from her. McColloster reviewed district records and learned his former patient never received the card.

"I don't know what happened to her," he says today. "It's possible that she might have died."

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